Distal cholangiocarcinoma (staging)

Last revised by Henry Knipe on 10 Mar 2023

Distal cholangiocarcinoma staging is defined according to the TNM staging classification of the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC). As of 2018, the staging criteria are in their 8th edition and reflected below 1. These criteria apply to cancers of the distal (extrahepatic) bile ducts, while cancers of the intrahepatic and perihilar bile ducts are staged differently.

  • TX: primary tumor cannot be assessed 
  • Tis: carcinoma in situ/high-grade dysplasia
  • T1: tumor invades the bile duct wall with depth <5 mm
  • T2: tumor invades the bile duct wall with depth 5–12 mm
  • T3: tumor invades the bile duct wall with depth >12 mm
  • T4: tumor involves the celiac axis, superior mesenteric artery, and/or common hepatic artery
  • NX: regional lymph nodes cannot be assessed
  • N0: no regional lymph node metastasis
  • N1: 1-3 positive regional lymph nodes
  • N2: 4 or more positive regional lymph nodes
  • cM0: no evidence of metastases
  • cM1: distant metastasis
  • pM1: distant metastasis, microscopically confirmed
  • stage 0
    • Tis, N0, M0
  • stage I
    • T1, N0, M0
  • stage IIA
    • T1, N1, M0
    • T2, N0, M0
  • stage IIB
    • ​T2, N1, M0
    • T3, [N0, N1], M0
  • stage IIIA
    • ​[T1, T2, T3], N2, M0
  • stage IIIB
    • T4, [N0, N1, N2], M0
  • stage IV
    • [Any T], [Any N], M1

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Cases and figures

  • Case 1: T1N0
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